A year after many Coloradans saw massive hikes in individual heath insurance premiums on the state exchange, people can expect much more modest increases to their premiums this time around — with some even seeing significant savings.

The small group market — health plans for small employers with between two and 100 employees — will see a 7.28-percent average increase.

“The 2019 premiums are the lowest we’ve approved in years, with minimal increases and, in some cases, decreases,” Interim Insurance Commissioner Michael Conway said in a statement. “This is a dramatic change from last year’s severe increases, which were exacerbated by instability at the federal level and the Trump administration’s last-minute decision to cut off cost-sharing reduction payments.”

Roughly 250,000 Colorado residents get their health insurance on the individual market. Of those, more than 180,000 are on the exchange, known as Connect for Health Colorado, which was created in 2011 after the passage of the Affordable Care Act.

More than 100,000 Coloradans who qualify for premium tax credits — those who make under four times the federal poverty level — will actually see, on average, a 24-percent decrease from last year if they renew the same plan, according to the Division of Insurance. Switching to the lowest-cost plan in the same tier could save people up to 50 percent over premiums from a year ago.

“There are two words of the day,” Conway said in an interview. “Stability and shop.”

While premium hikes mostly have stabilized, Conway urged everyone on the individual market to take the time to compare plans because there are sizable savings to be had.

“Don’t just take what you had last year,” he advised. “By shopping, people can really help themselves mitigate any increases or really see some savings.”

Health care experts realize, however, that it can be daunting to ask people to switch doctors.

“People have a tendency to get comfortable with what they have,” said Adam Fox, director of strategic engagement for the Colorado Consumer Health Initiative. “It’s a fair amount of hassle to look at what option might make more sense but still provide care for someone’s needs.”

Still, Fox said, it’s important to realize that this year you may be able to reap more savings by switching plans instead of re-enrolling.

The same seven health insurance companies that sold individual plans in 2018 are returning for 2019, according to the Division of Insurance. Companies under the Anthem umbrella — HMO Colorado and Rocky Mountain Hospital and Medical Service — will see premium decreases (0.2 percent and 2.6 percent, respectively). On the other end, those covered under the Denver Health Medical Plan will see 21.6-percent premium hikes.

The number of plans across the state, and within each geographic region and county, will remain similar to the numbers from 2018.

Those with gold plans on the individual market got some good news: Insurers requested a 6.85-percent increase in premiums but were only approved to hike rates by 3.8 percent. Bronze plans will increase by less than 1 percent, though silver plans will bump up by nearly 12 percent.

So why the new level of stability? For one, Colorado followed the lead of other states and got creative. After last year’s monster premium hikes, insurers adopted a new strategy. It’s called “silver-loading,” and it’s all the craze in wonky health care circles.

“Economists came up with it the summer after Trump came into office, and at first it really just bounced around on Twitter,” said Joe Hanel, managing director of communications for the Colorado Health Institute. “Colorado thought, ‘There’s no way the feds would let us get away with this.’ Now the state’s doing it, too.”

Silver-loading is a strategy — a loophole, really — that shields those who qualify for health care subsidies from big premium hikes. When the Trump administration ended the Affordable Care Act’s cost-sharing reduction payments in 2017, insurers lost a big source of revenue to reduce co-payments and deductibles for low-income people.

With this silver-loading quirk tucked into the ACA, however, insurers can now pack their premium hikes into silver plans, which increases federal subsidies for all plans.

“If you qualify for those tax credits,” Hanel said, “you could get a really great deal this year.”

But for many people who do not qualify for these subsidies, even modest premium hikes still hurt. Especially on the back of last year’s double-digit increase.

“Today’s news is more a lack of bad news than good news for those folks,” Hanel said. “They still could shop around, and if they shop around then they might be able to find a plan for a little less than last year. But in some counties there’s still only one carrier.”

Overall, health care professionals largely were encouraged by the moderate rate increases, even as they called for new ways to lower health care costs.

“I think we shouldn’t necessarily be fooled that we’ve got cost issues addressed,” Fox said. “If we don’t really address underlying costs, we’re still going to see increases to premiums year after year. We need to do something if want to rein them in.”

Sam Tabachnik is a breaking news reporter for The Denver Post. He previously wrote for NBC News, the Washington Post and the New Orleans Times-Picayune. A Boston native, he's not afraid to root for Tom Brady in the Mile High City.

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